Pharmacy Services

pharmacy searchableCenCal Health Pharmacy Services provides a comprehensive pharmacy benefit that includes formulary management, a robust pharmacy network, and quality customer service. Our pharmacy network spans both Santa Barbara and San Luis Obispo Counties providing our members with convenient pharmacy locations.

Pharmacy Benefit Manager

CenCal Health has contracted with MedImpact as its Pharmacy Benefit Manager (PBM) to assist in the administration of our pharmacy benefit.

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MedImpact provides: 

  • Claims processing
  • Pharmacy network management
  • Prior authorizations
  • Customer service
  • Drug utilization management services

CenCal Health Pharmacy Team shall oversee MedImpact’s administrative and daily operational role. To contact MedImpact, call: (800) 788-2949.


Our Promise: Our Pharmacy Team is committed to providing consistent, compassionate, local support.

Opioid Update 2018

CenCal Health Pharmacy Update

2018 Opioid Morphine Equivalent Dose (MED) Limit

CenCal Health and its Pharmacy Benefits Manager (MedImpact), are working together to communicate formulary changes to plan providers. With the approval of CenCal Health's Pharmacy & Therapeutics Committee and in coordination with MedImpact, CenCal Health has begun a Multiphase Implementation Plan to deter over-utilization of opioids, and update utilization management measures. 

Effective 7/1/2018, CenCal Health will be implementing the following MED (Morphine Equivalent Dose) edits to help minimize the over utilization of opioids: 

  • MED (Morphine Equivalent Dose) >120mg

  Soft-Edit at the pharmacy, can be overriden by the pharmacy

  • MED (Morphine Equivalent Dose) >200mg
Hard-Stop at the Pharmacy, Prior Authorization would need to be submitted to justify the MED>200mg

In an effort to minimize disruption to members on Chronic Opioid Therapy, we are notifying providers of the MED limits that will be effective 7/1/2018. For providers with members over the future MED limit, please see the recommended actions below to ensure that there is no disruption in therapy. 

Actions to Take: 
  1. Assess patient and review diagnosis, treatment plan, and possible titration from medications and or willingness to obtain addiction treatment from the County Drug and Alcohol Services Program. 
  • Santa Barbara County: 1-888-868-1649
  • San Luis Obispo County: 1-800-838-1381

    2. If member's medical condition necessitates continuation of therapy above the 200mg MED, the following information must be submitted to obtain Prior Authorization, starting 7/1/2018: 

  • Diagnosis with medical justification 
  • Pain Assessment
  • Urine Screening-Shows concordance with prescriptions
  • Attempts made to titrate therapy
  • Alternative treatment/therapies attempted

Please contact CenCal Health Pharmacy Services Department at (805) 562-1080 if you have any questions. 



Synagis® RSV Season

Synagis® Pharmacy Update: RSV Season

CenCal Health would like to assist our members and providers in preparation for the upcoming RSV season. In conjunction with the Department of Health Care Services' Children's Medical Services Network, the Synagis® prophylaxis season will begin November 1, 2018, and run through March 31, 2019. Medical Request Forms (MRFs) will be accepted beginning October 1st for initial administration beginning November 1st to ensure that the infant's child/weight is current.

Synagis® is required to be ordered through our Specialty Pharmacy vendor, Diplomat Specialty Pharmacy. Order forms can be obtained through the CenCal Health website at: www.cencalhealth.org or by contacting Diplomat Specialty Pharmacy directly at (877) 319-6337. Please contact CenCal Health Pharmacy Services Department at (805) 562-1080 if you have questions or need any assistance.



























Formulary Updates

DUR: Educational Articles

The purpose of this educational intervention component of DUR is to improve the quality and cost-effectiveness of prescribing and dispensing practices for Medi-Cal recipients. Educational interventions include ongoing dissemination of information through the Medi-Cal provider bulleting process about clinically important, drug-specific therapy problems. 

Alert-Mandatory Use of CURES 2.0 Begins October 2, 2018

2018 Immunization Updates: Flu, Tdap, HepB, Zoster, MMR, Adult Vaccines

Drug Safety Communication Adverse Effects from Fluoroquinolone Antibiotics-July 2018

ProDUR Update Additive Toxicity Alert Now Focused Only On CNS Depressants

In the Pharmacy: Pharmacist Furnishing Nicotine Replacement Products

Drug Safety Communication: New Age Limit of Opioid Cough and Cold Medicines-February 2018

Clinical Review: Drug-Induces QT Interval Prolongation-August 2017